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[精神科患者脑电图中右后突出的间歇性慢波的意义]

[Significance of intermittent slow waves with right posterior accentuation in the EEG's of psychiatric patients].

作者信息

Ulrich G, Otto W

出版信息

Fortschr Neurol Psychiatr. 1984 Feb;52(2):48-61. doi: 10.1055/s-2007-1002001.

Abstract

The study was based on the frequent occurrence of intermittent slow waves right-posterior accentuation (IRP) in the EEGs of psychiatric patients. With regard to the EEG-phenomenon we present a detailed morphological and functional description as well as an evaluation from a developmental point of view. According to case histories a clinico-psychopathological characterization of the patients with IRP is given. The IRP-phenomenon can be interpreted electrogenetically against the background of and in connection with the so-called slow alpha variant rhythms as well as the posterior slow waves characteristic of children and adolescents. These patterns have in common a certain tendency to right-sided accentuation. In accord with a hypothesis (which has been derived from other observations and considerations) of a "maturation gradient" which favours the left hemisphere, we try to explain the IRP-phenomenon as an expression of a maturation deficit. Whereas the slow alpha variant rhythms and the posterior slow waves characteristic of children and adolescents appear bilaterally for the most part, IRP by definition, limited to the right hemisphere, may be considered as a less pronounced form in comparison. Deriving from clinico-psychopathological assessment the relationships are as follows: Patients with IRP account for about 5% of the in-patients in our psychiatric hospital. The IRP phenomenon seems to be closely linked to the male sex. Although a clear relationship with nosological categories (ICD) could not be proved, it seems that patients suffering from schizophrenic psychoses (ICD No. 295) are more frequently represented among the patients with the IRP-phenomenon than others. For the group of schizophrenic patients with IRP we found in contrast to a control group of schizophrenics without IRP a tendency to earlier onset of their disease. Compared with the control group it is found that the IRP groups consists of younger patients at the time of conducting this study. The two comparative groups of schizophrenics with and without IRP can be characterized by differences in the more or less pronounced manifestation of a fairly large number of AMDP items. Whereas for the IRP group a symptom pattern emerges with a hypermotoric -expansive accentuation, the control group seems to tend more towards a syndrome with depressive shading. The slight tendencies towards increased hereditary disposition as well as towards increased perinatal complications among the schizophrenic IRP patients necessitate further studies.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

该研究基于精神病患者脑电图中频繁出现的间歇性慢波右后突出(IRP)现象。关于脑电图现象,我们从发育的角度给出了详细的形态学和功能描述以及评估。根据病例记录,对患有IRP的患者进行了临床心理病理学特征描述。IRP现象可以在所谓的慢α变异节律以及儿童和青少年特有的后慢波的背景下并与之相关联,从电发生学角度进行解释。这些模式的共同特点是有一定的右侧突出倾向。根据一个(从其他观察和思考中得出的)有利于左半球的“成熟梯度”假说,我们试图将IRP现象解释为成熟缺陷的一种表现。儿童和青少年特有的慢α变异节律和后慢波大多双侧出现,而根据定义,IRP仅限于右半球,相比之下可能被视为一种不太明显的形式。从临床心理病理学评估来看,关系如下:患有IRP的患者约占我们精神病医院住院患者的5%。IRP现象似乎与男性密切相关。虽然无法证明与疾病分类(ICD)有明确关系,但患有精神分裂症性精神病(ICD编号295)的患者在有IRP现象的患者中似乎比其他患者更常见。与无IRP的精神分裂症对照组相比,我们发现患有IRP的精神分裂症患者组有发病较早的倾向。与对照组相比,在进行这项研究时发现IRP组患者更年轻。有IRP和无IRP的两组精神分裂症比较组的特征在于相当多的AMDP项目表现程度或多或少存在差异。IRP组出现一种以多动 - 扩张性突出为特征的症状模式,而对照组似乎更倾向于一种带有抑郁色彩的综合征。精神分裂症IRP患者中遗传易感性增加以及围产期并发症增加的轻微倾向需要进一步研究。(摘要截选至400字)

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